Osteoarthritis (OA) is the most common rheumatic disease of the elderly, with 40 million Americans estimated to have radiological evidence of OA. As part of the ongoing studies of OA in the Baltimore Longitudinal Study of Aging (BLSA) we have presented the cross sectional prevalence in radiographic hand OA and the longitudinal progression of hand OA. We have also developed new grading scales that expand on the Kellgren/Lawrence scoring system, have validated them, and presented longitudinal studies on the rates of progression of each of the individual features on the new scale. The possible association of metabolic and physiologic factors with hand OA was studied in a subset of the BLSA evaluated by Kellgren/Lawrence scores. Estimates of fat mass and distribution, as well as muscle and bone mass and muscle strength were related to OA grade, but this association was not present when the age distribution of the higher OA grades was accounted for. A subset of these volunteers, those with 2 or more visits were evaluated for the effects of these risk factors on the longitudinal progression of OA. Aside from age >60 yrs none of the factors was significantly related to progression when tested by Cox multifactorial proportional hazards model. This study fails to support the hypothesis that physiologic and metabolic factors are associated with hand OA independent of their known association with age.